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Author
Topic: If you bleed, do you tell? At emergency, do you tell? (Read 13780 times)

I was reading Blixer's experience with his bike and was wondering, if someone was rushing to help me while I was bleeding, if I would say something like "be careful, I'm HIV+". I doubt I would say it like this, but then again.

Have you had a situation where blood was involved and you had to say something to warn the person?

I can see how someone wouldn't want to tell in either case, but personally I would, and do. I work in a hospital, and since it's expensive to insure healthcare workers (therefore expensive to us) we tend to help each other out. I get copies of a nurse's record for her, and later I go to her to dress a nasty cut. I ask her to wear gloves and I tell her why.

But even so I've made exceptions the other way--like the Occupational Health Nurse who never wears gloves when she's administering a TB test. I figure she can make that decision for herself. Of course, if there was a needlestick injury, I'd disclose.

In 2003 I was a passenger in a car that was hit at a high rate of speed with enough force that I ended up with a large gash on my forehead. When the paramedics arrived, my first thought was to tell them of my status, and I did. They were of course already wearing gloves but there was so much blood everywhere that I wanted it clearly known despite their precautions.

On the other hand, when I had blood drawn for my semi annual tests in early June, the lab technician didn’t have gloves on and I didn’t say anything since it was obvious why I was there.

I would and until now always told in the Netherlands where I have never had any problems. I would not tell in places where people would gossip or discriminate. Like my homeland. If something happened to me there I would probabaly avoid the hospital. It's just not worth it. I don't even want to think about that I hate the system there, there are some good staff but many who should not be in the field at all.

BTW the nurses here taking blood often don't wear gloves even when they see HIV-related tests.

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"If you keep one foot in yesterday, and one in tomorrow, you piss all over today". Betty Tacy

There are procedures and precautions in place for EM workers/technicians/nurses/doctors. But...I'd still inform (if I'm conscious) because it's the right thing to do.Like Daniel, I had a lab tech draw my blood without gloves. I mentioned it to the doc on my follow-up visit. (This was a specialist; not my regular doc) He promptly wrote her up! I felt badly for her because I had hoped he would have only reprimanded her. So I asked why and he said that as the co-owner of the clinic, he has liabilities to protect. She was putting herself at risk and possibly others she drew blood from.xxx,Mike

I think that all healthcare professionals know that they need to take universal precautions as part of their training. At my blood draws, the nurse always wears gloves. They do so anytime they have to use needles, or bodily fluids are involved. This is sanitary for the client, the nurse, and other patients.

I do not have a problem telling a professional that I am HIV positive, when it is relevant to their safety or my health. If I had an accident at work, I would find a way to protect others without disclosing my HIV status, because this is still a private matter for me. In this day and a age, I still fear discrimination and stigma from hosting the critter. I think that anyone who is in any helping profession receives training on Universal Precautions in California, do not know about other states.

I do EMT work at one of my jobs and universal precautions are just part of the routine, even down to applying a band aid. That goes for all the guys I work with who are not hiv pos.... I have thought about what I would say if I had a bleed on me personally. I would tell them to use UP on me before they touch me. I don't know if I would point blank tell them Im positive, but I think they would put two and two together..

Fortunately I have not been placed in a situation where I would need to make a decision to disclose, however if it was going to place someone in danger, I would warn them. I tend to be overprotective even with my doc and her nurses. I always remove my IVs when finished, put on my own bandages and throw the anything with blood in the hazard bin. I have one nurse who does not like to wear gloves when drawing blood or inserting my IV. I simply tell her she is not touching me until she slips on her latex. She thinks I'm a bitch and I think she's an ass.

When I read this, my first thought was that, of course, I would disclose. Then I thought a little more -- why would I disclose?? Do I want them to take "extra precautions" with me? That seems a bit dangerous -- they should be using Universal Precautions on everyone, all the time. As we all know, many people do not their true status, so relying on a disclosure to be "extra careful" is not a good idea. Now it is quite different if we are talking about non-medical folks helping in an emergency -- they don't have UP on their minds and some form of disclosure is definitely warranted.Having said all this, I probably would still disclose to a medical person -- it is important that they have a complete history for MY benefit -- what if I were to become unconscious and/or hospitalized. I would want them to know I have a condition that requires medication.

Hello, very interesting question . I had to think on it because my first reaction was of course but that is not always the case. If I was in an accident and was having to be treated by emergency services, yes, I would disclose. If I am in the doctor's office and they went to draw my blood without gloves, I would ask them to put some on, I have done this before. At home, my family knows if I am bleeding, Don't touch me, I will handle it myself and if I can't, call an ambulance. now work is a different matter. I have cut myself many times, slicing lemons or whatever, I tell them I have it covered if they try to help. Also, I throw away whatever it was I happened to bleed on, but would have done that anyway. So , it all depends on the situation. Good question. Cristy

I contemplated this while having a cigarette, trying to come up with a single instance where it would not be to the advantage of both me and the attending professional to be aware of my status and failed to come up with a single scenario.

I have had the misfortune of being taken to an ER by ambulance on more than one occasion, though never for anything bloody. I always disclosed.

As near as I can remember, every time I've disclosed to a medical professional I've been thanked but reminded that Universal Precautions render such disclosure unnecessary.

Brent(Who thinks that some EMTs are definitely crush-worthy)

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Blessed with brains, talent and gorgeous tits.

The revolutionary smart set reads The Spin Cycle at least once every day.

As long as HIV+ folk continue to live in fear because of their HIV+ status, we continue to help perpetuate the very stigma that we find abhorrent.

So in answer to your question Milker, yes I would tell. Just as I would tell if I had cancer or diabetes or epilepsy et al. I tell family and friends. I tell doctors, nurses and dentists. And I would tell a stranger if the circumstances were about what is in the best interest of my health and if they had to take extra precautions.

It took me a while to get here but I feel no shame about being HIV+, so I don't act as if I do.

Now may I pose a question to you: How are we supposed to get the message across to others that being HIV+ is nothing to be ashamed of if we don't believe it and act accordingly ourselves?

Melia

« Last Edit: June 24, 2007, 03:44:20 PM by sweetasmeli »

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The difference between cats and dogs is that dogs come when called, whereas cats take a message and get back to you.

The Emergency Department at our hospital has it flagged on the computer that I have Advanced HIV Disease and an updated list of all the medication that I take and what I'm allergic to. So if I'm brought in unconscious, they have all the information needed. The local fire department here that runs our EMS also knows. It also states in my hospital documentation to stabilize and immediate transfer to the University of Cincinnati and my Dr's Names. This is really not for their benefit, but for mine. Sometimes living in a small rural town has it's advantages.

I've never been in a situation where people didn't already know (like as far as getting blood drawn and stuff). If I was injured or something and I needed help from somebody and there was blood involved, I guess I wouldn't have an issue with disclosing but I also don't see how it would help either of us. If it was bad enough where I needed to be taken to the hospital, either they'd already be aware or they would be told.

I guess I'm not in a great place to reply to something like this because I hardly ever get to speak for myself (being underage and all). Not that I have an issue with doing that, it's just that usually before I get a chance to say anything one of my parents is already babbling away (in healthcare situations and stuff). I wouldn't feel an obligation to tell any random person that helped me if it wasn't serious or if they were helping me to get more help if it WERE serious, because I don't see how I would put them at any risk.

Eh. It's not that I'm afraid to or anything, I just don't see how it'd be of any relevance. So I get bit by a dog or something, someone helps me stop the bleeding and gets me bandaged up. So what?

Unfortunately I have been in a situation where I was transported to the emergency room after I was mugged and struck by a pistol on the forehead, breaking open my skin and sending blood spraying everywhere.I immediately told the ER personnel I was HIV poz when I arrived there.. But had I been unconscuious...well....they would have been on their own.

I've never been in a situation where people didn't already know (like as far as getting blood drawn and stuff). If I was injured or something and I needed help from somebody and there was blood involved, I guess I wouldn't have an issue with disclosing but I also don't see how it would help either of us. If it was bad enough where I needed to be taken to the hospital, either they'd already be aware or they would be told.

I guess I'm not in a great place to reply to something like this because I hardly ever get to speak for myself (being underage and all). Not that I have an issue with doing that, it's just that usually before I get a chance to say anything one of my parents is already babbling away (in healthcare situations and stuff). I wouldn't feel an obligation to tell any random person that helped me if it wasn't serious or if they were helping me to get more help if it WERE serious, because I don't see how I would put them at any risk.

Eh. It's not that I'm afraid to or anything, I just don't see how it'd be of any relevance. So I get bit by a dog or something, someone helps me stop the bleeding and gets me bandaged up. So what?

Senario: So you just been mauled by a pit bull (while delivering newspapers after school) and there is blood all over your arms and on one of your legs has a bad gash. A neighborhood resident witness the ordeal and is helping you bandage up your wounds till medics get there but you notice he's got a bandaid on his hand. He cut himself yesterday on a window pane, which he shattered when he tried to pry open a stuck window, and his wound is still fresh and has not sealed yet. This person helping you runs the risk of infection.

Senario: So you just been mauled by a pit bull (while delivering newspapers after school) and there is blood all over your arms and on one of your legs has a bad gash. A neighborhood resident witness the ordeal and is helping you bandage up your wounds till medics get there but you notice he's got a bandaid on his hand. He cut himself yesterday on a window pane, which he shattered when he tried to pry open a stuck window, and his wound is still fresh and has not sealed yet. This person helping you runs the risk of infection.

xxx,Mike

Perhaps in some parallel universe where everything is run on the logic made popular by the Am I Infected? forum this would concern me.

If it is a situation, such as, I cut myself at work, where I do not WANT to disclose, I would be like "hey, that is blood, be careful, you never know" Kind of reminding them of the universal precaution training we all go through. If it is a medical professional I will just say "hey I am poz". If I am knocked out, well, they are on their own.

Well, i find it important to say it. In some cases if we would have been told about the HIV status of a person, we would not be here.... off course this does not always refers only to injures or health care but other situations too.

Here in my country at the Hospital I attend they withdraw blood to an average of 200 people on daily basis. I have been there twice.. first time the person knew he was taking a cd4 test, he was wearing gloves anyway so i didn't mention it. Second time this other person was not wearing gloves and i told him... "this is going to be for a CD4 test, isn't it?" Off course i knew it was for a CD4 test, but i wanted to empathize him to be careful. He answered: yes. He took the blood and use an portion of cottom bigger than normal on my arm (not too big, just bigger than normal). I felt ok, he was not at risk... now if he would have not been looking at me with sad eyes.....

So well, i always disclose when meeting Drs, ID or dermathologist (the only i have seen in looooooooong time... cause i usually never got sick... until now)

Now may I pose a question to you: How are we supposed to get the message across to others that being HIV+ is nothing to be ashamed of if we don't believe it and act accordingly ourselves?

Melia, there is no question I disclose to health professionals, I've told my dentist and if I come to a situation where I get to the emergency before they can look at my file, I will tell them, that's no contest with me.

My question was more related to the kind of situation that mjmel described, where there is a good amount of blood and there is a real risk. I like sdcabincrew's answer: hey be careful, it's blood, get some protection. I guess I don't want people to run away if I say i'm HIV+ and needing their help !!

Unfortunately, in my job, I get to deal with all kinds of crap, from puke, to cuts, and various other things that a sky-mattress should never have to deal with. I always use the same protection, I even tell them, hold on, I need to get my gloves and crap and say "nothing personal, you can never be too careful, which they agree" I am telling you, the "hey watch it, that is blood, puke, semen, etc, get your gloves" always covers it when you do not want to disclose.

My question was more related to the kind of situation that mjmel described, where there is a good amount of blood and there is a real risk. I like sdcabincrew's answer: hey be careful, it's blood, get some protection. I guess I don't want people to run away if I say i'm HIV+ and needing their help !!

That's my point. If we continue to behave as though people should run away from us because of our HIV+ status, then people will continue to run away from us. So, as daunting a prospect as it may be, isn't it up to us (the ones with the knowledge and understanding about HIV) to start breaking the vicious circle?

Melia

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The difference between cats and dogs is that dogs come when called, whereas cats take a message and get back to you.

I simply tell her she is not touching me until she slips on her latex.

Slightly puzzled here:

I understand the need for Emergency crews to wear gloves at all times. My dentist wears them too and I disclosed on first appointment. I would disclose to any one trying to help were I to bleed badly.

But I fail to see the logic in insisting that a lab technician or nurse wear gloves for something as simple as drawing blood; assuming that we are talking about healthy individuals who come for their regular lab draw, I fail to see where the risk is.

We are constantly reminded, in forums like "Am I infected?", that copious amounts of blood, wound to wound rubbing and other gory actions need to be taken for contamination to occur outside the body. Perhaps those nurses and paramedics amongst us could clarify this?

Out of the many times I had to give some blood for testing only twice did the person wear gloves. On these two occasions I noticed they were uncomfortable with me and performed the worse jabs I've had in years, and with lipo, finding the vein is not a problem. When this happened I changed labs. I've had plenty of good experiences with well trained, informed people who do not treat me as a time bomb but as a human being they do not need to fear.

--Technically a person can draw blood without gloves and be just fine. Gloves will not stop a needle stick and as long as the person sanitizes their hands properly, they aren't in grave danger to themselves or to the patient if they don't glove up during a blood draw. I have been stuck with a needle twice and gloves didn't help me one bit. It is a JCAHO requirement, though. I have a much harder time feeling for veins through a latex barrier, so I often find myself popping out a finger of the glove anyway, but patients do complain and freak out, so I don't take them completely off usually. I would rather not stick patients a ton of times. And since it has gotten around my previous life in the ER, I sometimes get conned into starting IVs for the nurses as well, so especially if it is a hard stick or the person has nothing or if it is one of the babies, I make sure I can feel as well as possible. --As to the first question, it depends on the situation. In the health care setting, there is no need for me to tell every single health care worker because of universal precautions. If they are involved in my care and have a need to know, then sure I tell them. In real life, outside of the hospital, I would tell. The general public isn't trained in the proper precautions and I wouldn't want to expose them needlessly. I try to bandage myself up and clean my own blood up when I can.

I always tell medical professionals of my status. My first trip to an emergency room was in 1990, I told then, and I have everytime since then. I have found those people treat you with respect for having the decency and courage to alert them. You are treating them the same way you would want to be treated,if you were in their position.If someone did have a problem with it, I would be out of there,but to date, I have found only compassion,interest,and complete professionalism on the part of those in the medical community, from the person who answers the phone to the doctor.

Sorry to get a bit off topic but gloves should always be worn by lab technicians to prevent cross infections and in reality is more for my benefit than the health care worker. Common sense should dictate disclosure in other scenarios.

By not letting everyone know of my status does not mean that I am ashamed of being a carrier. I simply am aware of the climate of discrimination still alive and well at my workplace. At this point, it is not worth going through the trauma of a disclosure. It has nothing to do with my ability to perform my job duties. Disclosure is something very personal and those that do not engage in it for various reasons should not be made to feel badly about it as the environment is different for each person.

I would disclose anytime anyone would be in danger of becoming infected. But like the Stella storyline, just because there is blood does not mean there is real danger. If anytime there is blood involved requires disclosure, then we might as well wear a medic alert bracelet, or a hazzardous materials tattoo on our forehead. As far as I know, I have not heard of any good Summaritan ever having contracted this disease by helping someone. If anyone has any information on this I would really like to know. The good Summaritan Law, in this state says that you are never to put yourself at risk to help someone, but rather do everything you can do without putting yourself or the victim in danger.

Doctors and healthcare workers are at a higher risk and there have been cases of both being infected doing their work, though very rare. Unfortunately, gloves will not help with a strong needle stick. In my case, my status is already in the computer when I go get services, so no I do not anounce it everytime I am there.

Latex gloves obviously don't stop needlesticks - the rationale for health care workers to wear them is that they've been shown to reduce the amount of blood going through the glove by about 75%, which reduces the risk of infection to the HCW in the event of needlestick. I've not read any research that demonstrates people are more likely to stick themselves wearing gloves than without. IMHO a HCW who doesn't wear gloves is being unprofessional.

I would always disclose to a HCW my HIV status in an emergency. That's not too tough - although this thread scared the crap out of me:

I wish I'd been on a placement in Barnet A+E to help out. And the periodic stories of paramedics who won't take positive people, or resuscitate them, scares me too. I'd still disclose, and then make a lot of noise afterwards if things didn't work out.

I think with good samaritans it's harder to disclose. I remember falling off my bike at night and cutting my hand open a few months after diagnosis. There was a lot of blood and I remember going home and getting pretty upset over it - I didn't even want to go to the hospital. I was glad nobody had stopped to help.

It's a crappy feeling. I guess if I fell off my bike now in the daytime and people rushed to help I'd ask them not to touch my injury - if pressed I'd probably say I had hepatitis or something until the ambulance arrived - there's just less stigma attached. It's horrible thinking about this stuff when you're cycling around London... I guess it's just one of the myriad of ways HIV affects our lives.

No I can't! I'm not likely going to ever have to learn now - that's very much a surgical thing, being able to tie a knot one-handed in the bottom of an egg cup!

I remember reading an article interviewing a TV chef over here, who was married to a surgeon. She said they used to go out for drives and he would drape one arm around her. When she'd get home she'd find he'd covered one side of her head in knots of hair!

Yes I would tell. In my opinion, in order to receive the best medical care at that moment, the medical people need to know my health history. I am on a lot of meds, and have many allergies. I don't want to be given a medication that could have a serious reaction.

Mike, I can suture one handed, but I have used two hands to knot gut sutures. It really depends on what type of suturing I'm doing and the size. In the morgue I always use two hand knots to finish loop stiching.

I was in shock when I hit a pothole on my bike and fell off an overpass onto the road below. I had many broken bones and a lot of blood. I frankly wasn't in any position to ponder the ethical ramifications of whether or not I should disclose. All I wanted was for the pain to stop. I think that we can ponder this forever.. but the very nature of a medical emergency is such that the person being cared for is not always in a position to check off all the appropriate right things to be done. There are standards and procedures for medical professionals to use when dealing with any situation where there is blood involved. I suppose if you can disclose, you should. But, really, I'm not going to lose any sleep over it.

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Floating through the void in the caress of two giant pink lobsters named Esmerelda and Keith.

By not letting everyone know of my status does not mean that I am ashamed of being a carrier. I simply am aware of the climate of discrimination still alive and well at my workplace......Disclosure is something very personal and those that do not engage in it for various reasons should not be made to feel badly about it as the environment is different for each person.

I may be wrong (please correct me if I am) but I am presuming that this part of your post was partly in response to my post. I guess when I wrote "I feel no shame" in my original post here, I could have been more general and said something along the lines of "I feel in no way uncomfortable" or the like.

My remark that HIV+ folk help perpetuate the stigma against themselves by not disclosing is in no way meant to make people feel bad. I'm just pointing something out for how it is. I guess where I'm going with that line of thought is: If we don't like the way we are stigmatized then we should be a part of the change we wish to see. If we are not prepared to be a part of that change, then in developed countries we really have no place complaining about the stigma.

And yes, you are correct, disclosure is something very personal, which should be done only if/when an individual is ready. But if they never feel ready, they shouldn't really complain about 'having to hide'. We are all free to live as we wish, but - as bitter a pill as it is to swallow - there lies no merit in complaining about any situation if we are not prepared to try to do at least something to help change it.

Melia

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The difference between cats and dogs is that dogs come when called, whereas cats take a message and get back to you.

I admire you for being a very free spirit and going to live in a new place. But I think that part of the reason you are leaving the paradise you live in is because of the gossip mill and the discrimination you face there (from reading your previous posts) because of your decision to disclose. So if you really want to make a difference would iit not make sense to stay?

I would also like you to consider that our lives are very different. I am a very rooted person. I have a house a career, and a very well paying job. I am not materialistic at all, but need the security that my life offers at this point, because I am not getting any younger. Again, I wish I could have done what you did in my life. I have always admired people who can go live in a new place, start a new life.

Were I younger like you, I might be a more of a rebellious whipper snapper. All that I have worked very hard for could be in jeopardy if I were not careful on who I chose to disclose to. Those that are important to me, and those that are relevant in keeping me healthy, so that I may continue to perform my job in the human services field, know my status. My job does make difference with people who both have and do not have HIV. And though you seem to have very little faith in me that I may some day be comfortable enough to disclose, well I hope that will not be the case.

They say there are laws here to protect me, but an employer can get rid of you using other excuses, and though I am comfortable financially, I would not survive the emotional, nor financial strain associated with fighting any entity at this point. My health is the most important thing in my life. Selfish as that may sound. Even doctors who work where I do have cautioned me about taking on this battle at this point.

Again, I truly admire you and your decision to be so open about your status and your free spirit.

Disclosing to everyone I know would be a wonderful thing. However for some disclosing can have its consequences. I totally understand what you are saying Carolann. Sometimes job/career does need to come first because without that we have no security and more than likely no health insurance. I for one would choose "hiding"..and still bitching of course..and keeping my health insurance and good job. Yes it would be great to just tell everyone and some good things could come of it. Unfortunately sometimes the bad can outweigh the good depending on the person/situation. Oh, and Carolann, because life can be so unfair sometimes, you have EVERY RIGHT to complain. Venting and bitching is what helps most people cope and get through the day. I get tired of people saying..disclose..tell everyone! Help destigmatize the disease. I understand the argument to a point..but they dint have to live your life and walk in your shoes. Different things work for different people.

I always Disclose, in the ER and if I go to a new Dentist or DR of any kind, I always tell them I'm poz.

Like Christine says, they could give you a drug that may cause a problem.

But I like disclosing, because it makes me feel good, for a reason I'm not sure I fully understand.

It relaxes me.

Plus, I'm proud of the fact I have survived this HIV for 23 years. Aztec (Mother Mark) always tells me that it helps reduce the stigma if they see a healthy looking person with HIV. That was a "pearl of wisdom"

I cut into my finger with a ax last winter and was sent to the ER at Sutter. My ID Doc practices there and at about 4 other medical facilities in 3 counties. I introduced myself as his patient from the Center Of HIV Prevention and Care. He only treats HIV patients so enough said.

If I had not been able to get myself to the ER and required additional help, I don't think I could accept the kindness of strangers. Have the best dayMichael

I guess this would be another thread, but in France it's illegal to not help someone that is "in danger". This is subject to interpretation, but you could, if you follow the law, get sued by someone that is heavily bleeding and you're not seeking help for the person. I don't know if other countries have this in their laws. But let's see i'm bleeding and I disclose that I'm HIV+, and the person runs away and doesn't call for help, it is grounds for suing. Of course, "in danger" is always subject to interpretation...

I think that part of the reason you are leaving the paradise you live in is because of the gossip mill and the discrimination you face there (from reading your previous posts) because of your decision to disclose. So if you really want to make a difference would iit not make sense to stay?

The reasons I am leaving Greece actually have nothing to do with the discrimination I have faced here, although that indeed has been upsetting at times and definitely challenging; in fact I was all ready to start getting involved in some HIV activism here prior to my decision to leave.

I admit that I recently posted about “scratching the days off till I leave this backward place” but that was more about the mini rant path I was on at the time of posting than about the backwardness driving me away. And, in all fairness, I dealt with the issue at hand head-on at the time, which is how I deal with most things.

I am actually leaving because I miss my family and main nucleus of friends and I’ve realized that they are the priority in my life. My time here was all part of an adjustment and healing period and now that chapter is over and I’m ready to go home. In addition, reliable healthcare and better work/study opportunities are more available back home. But the main reason is family and friends; if they were here I’d reconsider staying; because damnit, I am going to miss waking up to daily sunshine and the awesome views.

Incidentally, I actually have made a difference here to quite a few people, whose lives had never before been touched by the issue of HIV. By being open about my status, I have made several friends and educated them and a few others along the way. True enough some have remained ignorant but I am realistic enough to realise that you can’t educate everyone, especially those who don’t wish to be educated.

The fact that I have made a small difference here has shown me that I will be able to make a huge difference in my homeland, where the language barrier and bureaucracy won’t stand in my way. And I fully intend to embark on this following my return.

Again, I truly admire you and your decision to be so open about your status and your free spirit.

Thank you. It hasn’t always been easy but it has been totally worth it.

I fully stand by the viewpoint I stated earlier:As long as HIV+ folk continue to live in fear because of their HIV+ status, we continue to help perpetuate the very stigma that we find abhorrent, whether we mean to or not. And in developed countries especially, if we are not prepared to be a part of that change we wish to see, then we really have no place complaining about the stigma.

Melia

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/\___/\ /\__/\(=' . '=) (=' . '=)(,,,_ ,,,)/ (,,,_ ,,,)/ Cats rule!

The difference between cats and dogs is that dogs come when called, whereas cats take a message and get back to you.